Clinical standards for antimicrobial stewardship in TB care

Brehm, TT; Akkerman, OW; Sotgiu, G; Tiberi, S; Chang, KC; Dheda, K; Duarte, R; Vambe, D; Udwadia, ZF; Chesov, D; Mendelson, M; Iswari Saktiawati, AM; van Ingen, J; Eyuboglu, FO; T&#228;ngd&#233;n, T; Quang Vo, LN; Riccardi, N; Moschos, C; Friedland, JS; Lillebaek, T; Chandy, SJ; Caminero, JA; Thwaites, G; Gandra, S; Thursky, K; George, IA; Konstantynovska, O; Fatima, R; Yim, JJ; Kwak, N; Olaru, ID; Gillespie, SH; Kherabi, Y; Perl, SH; Gr&#248;nningen, E; Rodrigues, C; Bjerrum, S; Bange, F; Cox, V; Cirillo, DM; Saluzzo, F; Hara, GL; Wagner, D; Ismail, N; Sloan, DJ; Eshun-Wilsonova, I; Zeng, M; Cantero, C; Vasankari, T; Mandalakas, A; Kay, A; Ness, T; Torrico, MM; G&#252;nther, G; Kuksa, L; Guglielmetti, L; Garc&#237;a-Basteiro, AL; Marks, GB; Pulcini, C; Lange, C

Author(s): Brehm, TT; Akkerman, OW; Sotgiu, G; Tiberi, S; Chang, KC; Dheda, K; Duarte, R; Vambe, D; Udwadia, ZF; Chesov, D; Mendelson, M; Iswari Saktiawati, AM; van Ingen, J; Eyuboglu, FO; Tängdén, T; Quang Vo, LN; Riccardi, N; Moschos, C; Friedland, JS; Lillebaek, T; Chandy, SJ; Caminero, JA; Thwaites, G; Gandra, S; Thursky, K; George, IA; Konstantynovska, O; Fatima, R; Yim, JJ; Kwak, N; Olaru, ID; Gillespie, SH; Kherabi, Y; Perl, SH; Grønningen, E; Rodrigues, C; Bjerrum, S; Bange, F; Cox, V; Cirillo, DM; Saluzzo, F; Hara, GL; Wagner, D; Ismail, N; Sloan, DJ; Eshun-Wilsonova, I; Zeng, M; Cantero, C; Vasankari, T; Mandalakas, A; Kay, A; Ness, T; Torrico, MM; Günther, G; Kuksa, L; Guglielmetti, L; García-Basteiro, AL; Marks, GB; Pulcini, C; Lange, C;
Details: Publication Year 2025-12,Volume 2,Issue #12,Page 716-726
Journal Title: IJTLD Open
Publication Type: Guideline
Abstract: BACKGROUND: While antimicrobial stewardship (AMS) is essential for combating antimicrobial resistance (AMR), TB-specific AMS strategies remain poorly defined. METHODS: An international panel of 62 experts participated in a Delphi process. Using a 5-point Likert scale (5 = strong agreement; 1 = strong disagreement), participants evaluated 10 draft clinical standards developed by a core coordination team. A standard was adopted if ≥90% of respondents rated it three or higher, according to a predefined consensus threshold. RESULTS: All 10 standards reached the consensus threshold and were adopted: Standard 1, integration of TB into national AMR action plans; Standard 2, implementation of TB surveillance systems; Standard 3, education of health care providers, individuals affected by TB, and the public; Standard 4, integration of TB into AMS activities; Standard 5, establishment of expert consultation services; Standard 6, targeted testing and preventive treatment for individuals at risk for TB; Standard 7, access to timely and comprehensive drug susceptibility testing; Standard 8, prioritisation of efficacy, safety, and resistance prevention in TB treatment regimens; Standard 9, clinical and microbiological monitoring of treatment response; and Standard 10, assessment of adherence, drug exposure, and resistance in treatment failure. CONCLUSION: These clinical standards aim to support clinicians, programme managers, and public health authorities in implementing effective, TB-specific AMS strategies.
Keywords: antimicrobial resistance; drug resistance; rifampicin resistance; tuberculosis
Department(s): Infectious Diseases; Health Services Research
Publisher's Version: https://doi.org/10.5588/ijtldopen.25.0522
Open Access at Publisher's Site: https://doi.org/10.5588/ijtldopen.25.0522
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-01-20 12:06:12

Last Modified: 2026-01-20 12:06:31